This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Vetter, T. R. Search for Related Content PubMed PubMed Citation Articles by Vetter, T. R. Related Collections Economics and Health Care Research Pain Medicine

---

ECONOMICS, EDUCATION, AND POLICY

The Application of Economic Evaluation Methods in the Chronic Pain Medicine Literature

From the Department of Anesthesia, Indiana University School of Medicine, Indianapolis, Indiana.

Address correspondence to Thomas R. Vetter, MD, Department of Anesthesia, Riley Hospital for Children, Room 2001, 702 Barnhill Drive, Indianapolis, Indiana 46202. Address e-mail to tvetter{at}iupui.edu.

Abstract

BACKGROUND: The relative efficiency of a health care intervention or health status improvement realized for a given amount of resources expended can be determined using cost-effectiveness analysis or cost-utility analysis.

METHODS: An extensive chronic pain-focused search was undertaken of the MEDLINE, EMBASE, and SCI-EXPANDED databases. A total of 1822 unique citations were generated, with 142 studies subsequently categorized as incorporating one of seven recognized types of health care economic evaluation.

RESULTS: Of the 142 identified chronic pain-related economic evaluations published between 1988 and 2006, 30 incorporated a cost-effectiveness analysis and 29 incorporated a cost-utility analysis. The data are consistent with the previously reported chronological pattern of an increased overall diffusion of cost-utility analysis studies from the general medical and health services research literature into the medical subspecialty journals. However, only a few studies combined the economic analysis alongside a randomized controlled trial, the economic end-points in the trials had limited time horizons, and there was failure to address the protracted costs versus benefits of treating long-term and often recurrent chronic pain conditions.

CONCLUSIONS: Although it would appear worthwhile for researchers and clinicians to consider cost-effectiveness analysis and cost-utility analysis in their trial designs and treatment algorithms for chronic pain conditions, methodological improvements can be made in trial designs.